Endometriosis - Pearl Women Hospital

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Good day bloggers.

The month of March is observed all over the world as an endometriosis awareness month. While reading many recent journals for updates, and guidelines, we were getting updated about numbers, the gravity of endometriosis and the challenges ahead of us.

While being in clinical practice where every patient is unique and the symptoms appear to be as diverse as non-menstrual abdominal or pelvic pain, Infertility, Painful sex, or bowel-related symptoms, Bladder pain along with Lower back pain, Bloating, and consistent fatigue.

Endometriosis may be at the root of all of these symptoms, sometime in silent form or may be intense in the future and as the disease may present in different ways in different individuals. Unbearable pain is a constant complaint in the above cases.

Very difficult to diagnose based on a few scans and tests along with silence to bear with situations makes it hard for all. We are here to put the concerns of endometriosis beyond assumptions.

Let us find out more about endometriosis.

What is endometriosis?

ENDOMETRIOSIS is a condition where endometrial tissues and adhesions are found outside of the uterus and these cells respond to hormonal changes as if, they are within a uterus. such cells may be found in the bladder, pelvic region and bowel and other organs too. Such lesions of endometriosis get attached to other organs too. Such conditions then can cause intense pain as well as inflammation.

Endometriosis is not a period disease.

Unlike during regular periods, the pain of endometriosis isn’t caused by contractions of the uterus, but instead, comes from uterus tissue growing elsewhere in the pelvic cavity. This inflammation often results in a lot of pain. The intense pain from endometriosis can occur regularly, even in the absence of a menstrual cycle. Menstrual pain can be managed with over-the-counter pain killers whereas endometriosis pain is severe and may not be managed with over-the-counter painkillers alone. Period pain is labelled as dysmenorrhea and goes away after the periods.

It is a spectrum disease with a variety of subtypes and symptoms like pain, inflammation, infertility, development of endometriomas (“chocolate cysts”), fibrosis, formation of adhesions (fibrous bands of dense tissue), Gastrointestinal and other organ dysfunction, and much more, are common with endometriosis.

Detection of endometriosis takes time:

The real reason behind this lengthy detection is symptoms which are many and every patient may have different complaints. The silence kept over the symptoms often causes a delay in seeing an expert. To understand endometriosis, let us know about symptoms which cannot be ignored and can help to seek the help of an expert.

Symptoms often reported but not limited to are,

Pelvic Pain in the abdomen, Painful intercourse and sexual activity, Leg pain, lower back pain etc. Most of the time, symptoms appear to be on the surface and are mild. As time passes, lesions go deeper and chronic symptoms become noticeable. Does it mean, every symptom is of endometriosis? No. Rather, put it like this. We need to know, what is normal and what not so normal or causing concern is. Watch out for the symptom intensity, duration, frequency, medication response, and symptoms’ reoccurrence. Make a note of it and keep it handy as it can form the basis of the right history taking.

So, when should you go to the doctor?

If the pain is severe and comes days before the period and persists after the period, then it could be endometriosis. See a gynaecologist and get tested. Another indication is if the pain doesn’t go away after taking painkillers or other analgesic pills, or over the period, intensity, duration & episodes increase with time.

Endometriosis is certainly not in your head, and we hear your silence.

Let’s understand that pain has intensity and every individual has a different tolerance capacity. That is why we at Pearl Women’s hospital understand your pain and developed a protocol to address your concerns. We understand pain as an obstacle that affects your daily routine and needs prompt treatment.

Endometriosis slowly and steadily takes over the body, intensity increases over time. You may be scaling new highs on the personal as well as professional front while being with endometriosis. Gold standard Laparoscopic examination may confirm the diagnosis and we understand, not all illnesses are visible and still be powerful to affect lives.

Let the silence be deleted and let’s practically know more about endometriosis.

Endometriosis is rare, what is your take?

Endometriosis is not rare as there is 10% of women suffer from it, which means 1 out of 10 women suffer from it.

Endometriosis is now a commonly diagnosed condition in gynaecology and you are not alone. The cases like PCOS and uterine fibroids are widely seen and spoken about but with endometriosis, the case is different. As there is no defined biomarker or blood test which can reveal endometriosis, its severity and progression. It simply does not mean, there is no progress in understanding disease in depth. There are multidisciplinary approaches to reducing effective symptoms.

After detection and with a surgical approach, can endometriosis be cured?

Currently, there is no cure for endometriosis, there are treatments available to reduce the symptoms and their intensity. The key whole surgery is still major surgery. There are multiple options available to control symptoms like medications, IUDs, surgeries, Pelvic floor physiotherapy, Prescription pain killers, supplements etc.

Your treatment plan will be tailor-made as per your conditions and may not be identical to others,

Be gentle to yourself. It ok, if you are not performing at your best sometimes.

Let’s understand some facts in a nutshell

As of now, Endometriosis has no cure but effective treatments are available which offer relief.

Endometriosis is a chronic, systemic inflammatory disease.

Treatment for endometriosis is not the same or one size fits all approach.

Pregnancy is not a cure for endometriosis

Birth control can offer temporary relief.

The right diagnosis at right time is the key which helps in the faster and more effective treatment

The silence over endometriosis is a matter of concern

A lot needs to be done and the least we can do is, seek the guidance of the right doctor.

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The issue with Endometriosis isn’t just the pain and disruption of lifestyle, but the fact that diagnosis may take anything upto 7 years, with a surgical procedure being required for a definitive diagnosis. The gold standard confirmatory test for endometriosis is Laparoscopy. The condition, as such, is not curable but specially trained experts like Dr Chaitanya Ganapule offer state-of-the-art treatment options including 3 D Laparoscopic surgery at Pearl Women’s Hospital, Pune.

10 % of menstruating women suffer silently due to endometriosis. During the normal menstruation process, the cells of the uterus lining called endometrium build up & if there is no pregnancy, the cells shade up causing menstrual flow. Women with Endometriosis, too, develop such cells, which not only look, and act like endometrium outside the uterus but also in the other reproductive tissues. Such cells respond to the hormonal changes, so there is build-up & shedding of cells, causing small bleeding in the pelvis. This causes inflammation and scarring of endometrium tissues. The result is painful, heavy, long periods, and cramps.

The exact reason for this pain may be due to chemicals released during the process, hormonal changes etc.

Suffering in silence not only delays the diagnosis but complicates the treatment further. Medical management may have to be replaced by high end surgical treatment.

So, when you feel, or realize that your menses or periods are far more painful and heavy compared to your friends and cousins, do visit a specialist who has extensive & practical knowledge of female reproductive issues & is capable of fixing the issue well in time.

Dr Chaitanya Ganapule MD has taken training from a specialized Endometriosis surgery institute in France for surgical management of Endometriosis using 3 D Laparoscopy systems.

When you go to seek answers from the specialist It is important to jot down the questions, you need to seek answers for:

What causes the pain in the abdomen in Endometriosis?

Why it is so intense & not seem to be routine periods pain?

What are the treatment options available for the pain and for the disease itself?

Will it relieve the symptoms or condition itself?

What are the side effects of treatments?

What, if my symptoms don’t go away?

What lifestyle changes, do I have to make?

What will happen, if I don’t go ahead with treatment?

Will my fertility be affected? If yes, then what are the options?

Will my previous surgery is causing this pain?

Do I need to have multiple surgeries or chances of relapse of surgery?

Your doctor too will have a few queries, so make note of it.

What are the symptoms & how often do they appear?
When do they get worse or better?
Do any close relatives have such problems,
History of Endometriosis in the family?
What are the medicines you take currently?

Always keep a track of your symptoms.

Like Painful periods, Severe Cramps, Pain during sex & urination, Heavy bleeding, Nausea & vomiting during a period, headaches, constipation, Trouble getting pregnant, sleep patterns etc.

What is the importance of maintaining these symptoms?

You will never miss out on any symptom (relevant or irrelevant)

You will rightly inform the intensity with which it happens.

You will not downplay any symptoms that hurt you so much.

Diagnostic delay of 3 to 12 yrs in endometriosis,

Primarily a patient’s delay in reluctance in seeking the medical help
Preparedness of GPs to interpret the symptoms
Expert’s dilemma for differential diagnosis.
Diagnostic laparoscopic surgery for confirmation

Informed diagnosis has many challenges.

Whether confirmed or suspected diagnosis of Endometriosis is often the 1^sttime patients hear the word endometriosis.
Distress is the 1^stresponse along with confusing outdated content available all over.
Wrong or misleading info can delay the proper treatment, and can be very expensive as well as dangerous too.
Frequent visits to the clinic are necessary to access the extent of endometriosis.

Where to seek expert help for endometriosis @ PUNE?

We @Pearl Women’s Hospital & Yash IVF have excellence in endometriosis treatment and is situated at the central location of Deccan, Pune.

Dr Chaitanya Ganapule is an expert in Laparoscopic surgical removal of such tissues or fibroids or Polyps, is his forte and he is considered one of the top Gynaecologists for this procedure.

A reputed Laparoscopic and Hysteroscopic surgeon, Dr Chaitanya Ganapule has been trained at some of the best centres in France and Germany. He has a diploma in Pelvic Endoscopy from Kiel University, Germany, and A Diploma in Gynec Endoscopy from the University of Clermont – Ferrand, France. He has recently attended & completed the “Indian Workshop of the Franco-European Multidisciplinary Endometriosis Institut in France, in 2022. We are happy to offer our special ’EndometrioCEASE’ solutions to patients who wish to get rid of pain, restrictions and infertility.

IN A NUTSHELL,

There is no cure for endometriosis but specialized treatment can control the manifestations of the ailment.
Symptom management is the key focus.
Hormonal contraceptives, analgesics or pain killers and surgery are the options.
Women with Endometriosis are everywhere in Emergency wards, Primary care, Psychiatric help centres, schools & colleges with various health issues.
Endometriosis develops in stages, involving other organs with severity.
About 50% patients of with endometriosis suffer from fertility issues.
Hormones do not improve fertility, but IVF is often successful.
Warning signs demand PROMPT ATTENTION.
If pelvic pain, and period pain doesn’t stop with painkillers, see the expert on priority.

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Good day bloggers.

Every query about the endometriosis cure brings the spotlight on the concerns. Endometriosis in the true sense has united the various age group, races, and professions alike. This condition affects life, generates anxiety, and disturbs work-life balance for the sufferer as well as near and dear ones.

Endometriosis feeds on estrogen, so endometriosis starts as early as the 1st period, lasting beyond menopause in severe cases, in about 30% of the cases. As per the latest reports, 1 in 10 women suffers silently from endometriosis. The average age of endometriosis diagnosis is around 28 yrs, risk increases beyond 30 and peaks around 40 yrs. That’s why endometriosis is mainly a reproductive health concern.

It is estimated about 25 million women are suffering from endometriosis. Women with mothers & sisters having endometriosis are 5-6 times more likely to develop endometriosis as compared to others. The unbearable Pelvic pain, irregular menses & infertility are the symptoms but, often go unnoticed.

When the Warning signal becomes a red alert, the search for the cure starts. In most cases, the diagnosis of endometriosis takes 2 to 10 years & is the main reason for infertility. Health complications of endometriosis are immense and affect the body, mind & soul.

Pregnant women are often at increased risk of premature birth and miscarriages. The real threat is, the time endometriosis takes for detection & confirmation. This delay further affects the anatomy of the internal reproductive organs & the treatments are often complicated. Endometriosis diagnosis is often done with ultrasound, transvaginal scans or laparoscopy.

As endometriosis is an inflammatory condition involving the uterus lining, and pelvis which affects the surrounding areas too. As these cells are supplied with neurons, pain is often felt which is intense. These cells are outside the uterus lining and respond to hormonal changes during menstruation. So there is internal bleeding too.

Diagnosis of endometriosis itself is a challenge, so it is said, one who knows endometriosis, knows gynaecology. The reason why the cells stick outside the uterus wall & form linings is not known. The inflammation caused by such hormonal changes is a real concern. The inflammation has dead cells and toxic substances which make the internal environment of the abdomen toxic.

Removal of such cells which are grown outside the uterus is the most viable option but recurrences of such cells call for further surgeries which affect the structure & functions of ovaries. No wonder, it is a super speciality surgery to selectively remove these cells without damaging the structure of the uterus & other organs.

So, where is the cure for endometriosis? Let’s get the fact right, there is no cure for endometriosis but symptoms can be controlled with surgery & medications.

There are treatment options available for Pelvic pain & Infertility. Depending on Age, the severity of symptoms, degree of endometriosis (how deep the penetration of endometrium cell in the organ) and medical history of the disease, consulting a Gynaecologist will take the well-informed call.

The challenge of fertility preservation & pregnancy in case of severe endometriosis is tough to handle, and there are chances of endometriosis occurring again after a few years.

Can endometriosis be cured only with surgery?

There is no cure for endometriosis, & often laparoscopy surgery is the gold standard treatment in the first place. The removal of endometrium cells outside the uterus can offer guaranteed relief and control over Pelvic pain. The surgery needs to be repeated if endometriosis occurs again.

Laparoscopy is the gold standard therapy. The surgeon uses an instrument to inflate the abdomen with harmless gas and then inserts a laparoscope, into the abdomen through a small cut to see the growths.

The surgeon makes at least a few more small cuts in the abdomen and inserts lasers to,

Remove the lesions/scar, which is called excising procedure.

Destroy the lesions with heat and seal the blood vessels without stitches, by cauterizing or vaporizing process.

The goal is to treat the endometriosis without damaging the healthy surrounding tissues

To avoid or prolong the growth of endometrium cells outside the uterus after surgery, birth control pills & hormone therapy is often advised. The duration and dosage of such medicines are the expert gynaecologists’ forte, it requires constant monitoring of the ovary health.

Hormone therapy is used to treat endometriosis-associated pain. Hormones can be given as pills, a shot or injection, or a nasal spray. These medications stop the ovaries from producing hormones, especially estrogen. This will prevent the development of endometrium tissues or scars, but it will not stop the current lesion or growth of endometrium cells.

Here are a few ways to control symptoms of endometriosis & reduce the intensity of symptoms.

Pain killer medication: There are several medications available to help relieve the symptoms of endometriosis. Some people may find relief by taking over-the-counter painkillers or prescription drugs. It is to be noted, that all these medicines should be taken under the guidance of a gynaecologist. These pain killers often cause acidity & sometimes cause major complications like bleeding.
Eating right for endometriosis diet: Diet can help relieve the symptoms of endometriosis. For example, eating a healthy diet with fruits and vegetables can help improve health and may reduce the symptoms of endometriosis. Grapes, Apples, Strawberries, peaches, and Oranges offer good pain relief.
Food to avoid: High fats processed foods, caffeine, and Soy products, as they contain estrogen. Red meat too contains estrogen, so it is better to avoid
Rest, Relax & Mediate, take warm baths, and use of heating Pads.
Exercise: Exercise is internal cleaning and helps in reducing the pain intensity & increasing tolerance

One such center, which offers a multidisciplinary approach along with laparoscopic excellence is Yash IVF, Deccan, Pune. Under the able guidance of Dr. Ganapule & the team has successfully operated on tricky & complicated endometriosis cases. The hospital is known for the Endometrioses CEASE Clinic. Yash IVF offers online consultation too with prior appointments.

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Warm regards Dear readers,

We represent Pearl women’s hosp & Yash IVF, a hospital of repute in complete endometriosis care. We are often bombarded with questions & one of the common ones is, how severe is My Endometriosis and what can I do for relief?

Let’s address this concern.

Understanding endometriosis is the best starting point. As the word endometriosis relates to the uterus or womb, it is a muscular organ which is made up of 2 types of cells. Muscular cells that make the wall of the uterus, are called myometrium while other cells that are glandular make the linings of the uterus, endometrium. The uterus has many nerves & blood vessels that supply blood.

Endometrium cells have specific functions to provide the space for attachment to the embryo when the pregnancy begins. The function of these endometrium cells changes over time. During the menstruation cycle, the endometrium builds up to provide shelter & space for a fertilised embryo. If Pregnancy doesn’t happen, then these cells die & menstruation or vaginal period starts.

These endometrium cells respond to the hormones, such a well-structured womb is, an organ truly dynamic.

These endometrium cells when found elsewhere, or outside the uterus, ovaries, bladder, and pelvis too respond to the hormonal changes during periods, they tend to swell, causing inflammation & intense pain.

Delay in detection & confirmation of endometriosis is a result of mild to moderate symptoms of pain, bleeding, and cramps which are often neglected. There is no practical definitive marker to study the extent of endometriosis is available.

Pain, irregular bleedings, infertility, tiredness, bloating, fatigue, diarrhoea, and constipation are the probable symptoms of endometriosis which can have other causes too.

So, to address the concern, Is all endometriosis the same?

Endometriosis based on location can be ‘superficial endometriosis’, when there are lesions over the peritoneum & another is, ‘deep infiltrating endometriosis’ having growth infiltrates in the pelvic organs, like the bladder and rectum etc. Endometriosis has typical and atypical presentation, so their classification is of great importance and is improving day by day.

There are different degrees or levels of endometriosis, depending on, the number of organs involved and the degree of scarring and internal adhesions. This classification is of great importance to know,

The stages of spread & extent of damage it can cause

The treatment Plan for each stage & possible time & effort needed for the same.

To understand the progression of disease & impact on other systems like fertility.

The severity calls for additional external help through specialised drs/hospitals.

Involving patients to update the possible & realistic goals & complications of treatments.

American Society for Reproductive Medicine developed the grading of endometriosis. (ASRM and is based on the number of lesions & degree of infiltration/adhesions. This system of classification is not based on the severity of symptoms & is grouped into the following.

This system of classification is further refined by The Endometriosis Foundation of America (Endofound.org) has proposed a different classification using the anatomical location and level of infiltration.”

ENDO FOUND ENDOMETRIOSIS CLASSIFICATION.

One important point to recollect is, that there are many challenges for the operating doctor and may be considered a super specialty surgery. Even for the diagnosis, laparoscopy surgery is required, and the additional burden of infertility has to be addressed along with diagnostic delay to beat. To overcome, all these challenges, awareness & seeking expert help in time is essential.

One such center, which is generating excellence for ‘Endometrioses CEASE’ Treatment is Pearl Women’s hospital & Yash IVF. The centrally located @ Deccan, Pune center hosts an excellent in-clinic facility for local, interstate and foreign nationals which includes an in-house medical facility under one roof, including medicines, 24*7 expert medical help at the bedside, additional caretaker facility, pick-up & drop for the patients,

Dr. Chaitanya Ganapule is an eminent expert Laparoscopic surgeon & has impressive credentials, to be considered, as one of the top Gynaecologists for this procedure.

A reputed Laparoscopic and Hysteroscopic surgeon, Dr. Chaitanya Ganapule has been trained with the best centers in France and Germany. He has gained a diploma in Pelvic Endoscopy from Kiel University, Germany, and a Diploma in Gynac Endoscopy from the University of Clermont – Ferrand, France.

His learning with “The Indian Workshop of the Franco-European Multidisciplinary Endometriosis Institute in France, in 2022 is a great asset. We are proud to offer patient-specific ’Endometrioses CEASE’ solutions who wish to get rid of pain, restrictions and infertility. We promise to make your stay comfortable & memorable too.

The wholesome food & friendly patient care are hallmarks of the hospital. We do have online consultations for patients to avail the medical excellence in time.

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Painful menses, cramps, and heavy bleeding are common stories for many women and they may have a dozen different causes. They remain a puzzle to understand, diagnose & treat because not only are women reluctant to come to the doctor with these issues but they are brought up on the firm belief that these monthly periods have to be lived with. However, Endometriosis is a different ball game altogether. The pain can destroy your personal life, it lasts well beyond the menstrual cycle and is immune to medication. It may also delay pregnancy, make it more complicated and can progress toward infertility.

In fact, you can consider yourself lucky that you have been actually diagnosed as having Endometriosis because the only definitive diagnostic test is Diagnostic Laparoscopy.

Can you imagine, a diagnostic surgery simply to confirm the presence of endometriosis? Yes, there is no other test for a definitive diagnosis and it is up to the expertise of the Gynaecologist to recognise the symptoms and recommend a diagnostic Laparoscopy. It is quite another issue that most patients may reject this recommendation outright unless the suffering is too severe to bear.

No wonder, 30-50 % of the patients diagnosed with endometriosis often have had a struggling journey of infertility. This condition often remains underdiagnosed unless a couple faces issues in getting pregnant.

The real concern is that the couple is trying desperately for pregnancy and visits the gynaecologist only to find out that the cause is an incurable condition called ‘endometriosis’.

Endometriosis is a condition wherein the cells of the linings of the uterus are found outside the uterus, on other organs like the ovaries, fallopian tubes, or elsewhere in the body like the kidney, bladder or intestine.

How long does endometriosis last?

Endometriosis feeds on estrogen, so endometriosis starts as early as the 1^st period, lasting beyond menopause in severe cases, in about 30% of the cases. The only indication is failure to conceive. Silent or milder endometriosis has no symptoms. The control over the symptoms is one part and controlling the endometriosis is another side of the story and that’s why there are foundations of endometriosis in the world to address this concern.

How much is the burden of endometriosis for Pregnancy?

Let’s understand first, that endometriosis is inflammation of the endometrium, the lining of uterine cells. Inflammation is reddening, ballooning& swelling of linings, due to which, eggs may have a problem travelling from ovaries through fallopian tubes to the uterus.

There is scarring of tissues as the lining is disturbed. Eggs may get lodged and may not move. Fertility issues with endometriosis, often start with ovaries & fallopian tubes. While passing these barriers to fertilisation, women with endometriosis have potentially higher rates of miscarriage Preterm deliveries, Pre-eclampsia, and Caesarean deliveries.

So, what to treat first? Endometriosis or fertility issues

The simple answer is, that it depends on the severity of the conditions, health records of the women, age, etc. It is highly patient-specific & getting consultation from the experts is a must, as surgical removal through laparoscopy is a super speciality surgery and a lot can depend on the skills & expertise of the operating gynaecological.

Endometriosis diagnosis is the key to treatment,

Timely treatment of endometriosis not only improves the success rate of IVF but also helps in natural conception.

The cell growth as well as lesions (scarring of tubes) often leads to the delay or difficulty in travelling or implantation of embryos. The severity of endometriosis matters the most in the success of IVF. The gold standard investigation for endometriosis is surgical laparoscopy and biopsy. If pain is not controlled with simple analgesia or the diagnosis is suspected in a woman who is actively trying to conceive, referral should be considered. Early referral should be considered in women with abnormal examination findings,

A Myth attached to this situation is, that pregnancy can cure endometriosis.

Simple answer, it is incorrect. No pregnancy can cure endometriosis. The symptoms and severity may decrease due to pregnancy or lactation because of hormonal changes, but the scarring and pregnancy may further cause problems in the journey of parenthood.

Can IVF be successful with endometriosis?

If you have been diagnosed with endometriosis and want to start a family, IVF is a good option & the best solution too.

IVF success depends on women’s age, quality of eggs & sperms, medical history of the couple, lifestyle & stress, and Severity of Endometriosis etc. A special precautionary measure, if taken can increase the success of IVF. There are instances, seen & studied which say, the impact of endometriosis on IVF Success is on various stages with Poor implantation, low egg retrieval, quality of eggs etc.

Let’s know the facts about endometriosis & fertility.

Endometriosis is a common Gynaecological concern, which does not cause necessarily infertility or pain. Mild endometriosis is common & one will not have any problem in natural conception. As the severity increases, adhesions are the main concern & chances of natural conception are lowered.

What, if you decide to be silent on silent endometriosis?

The simple answer is, delay in diagnosis is because of symptoms which may be mild or seen as normal period pain. You can maintain the silence but silent endometriosis may not. It worsens over time & the growth of such unwanted cells multiply and can cause future complications.

Does medical treatment endometriosis?

Drug treatment for endometriosis does not improve fertility either during or after the treatment. It is documented for pain relief or preparation for surgery. It does offer symptomatic relief to the patient.

Does surgical treatment for endometriosis improve the chances of pregnancy?

It is well known & documented fact that surgical removal of such unwanted tissues with precision & accuracy, definitely improves fertility & reduces pain. The Surgical treatment is more valuable than diagnostic laparoscopy (look & see).

Laparoscopic Surgery is often hailed as the gold standard in case of endometriosis and expertise in doing so, is a branch of super speciality. We @Pearl Women’s Hospital & Yash IVF have excellence in endometriosis treatment and is situated at the central location of Deccan, Pune.

Dr. Chaitanya Ganapule is an expert in Laparoscopic surgery Removal of such tissues or fibroids or Polyps, is his forte and he is considered one of the top Gynaecologists for this procedure.

A reputed Laparoscopic and Hysteroscopic surgeon, Dr. Chaitanya Ganapule has been trained at some of the best centers in France and Germany. He has a diploma in Pelvic Endoscopy from Kiel University, Germany, and A Diploma in Gynec Endoscopy from the University of Clermont – Ferrand, France. He has recently attended & completed the “Indian Workshop of the Franco-European Multidisciplinary Endometriosis Institute in France, in 2022. We are happy to offer our special ’EndometrioCEASE’ solutions to patients who wish to get rid of pain, restrictions and infertility.

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